COVID-19 raging across our country. Millions of newly unemployed are wondering where their next paycheck is coming from. Major disruptions to our normal everyday life replaced by the rage of racial disparity exploding into city-wide protests and violence. A contentious election year. Is it any wonder that a recent CDC study revealed that 40% of adults are struggling with mental health or substance use challenges? This news shines an even brighter spotlight on the shortage of psychiatrists in every community across the country and the significant lack of funding for behavioral health treatment.
For decades we’ve been acutely aware of the abyss that exists between the medical and behavioral health worlds. Unfortunately, more times than not, individuals with a behavioral health or substance use condition (and their families) suffer alone. That is until the suffering reaches a tipping point and they end up in the Emergency Department either via the police or ambulance transport.
Once the ED physician clears the patient medically, the scrambling on the unit begins. Who can provide a timely psychiatric assessment? With a three week or longer waitlist for both a psych and/or substance bed, where will we send this patient if they require an acute level of care? With an on average waitlist of up to 25 days for an outpatient appointment, how can we ensure they don’t spiral into another crisis if he or she is deemed safe to discharge home?
The bad news is this scenario is far too common. The good news is that solving this issue doesn’t involve reinventing the wheel. There are models of care already proven to accelerate and improve access to behavioral health care. For example, our key strategic partner, Blaze Advisors, a North Carolina based healthcare consulting firm that uses Infina Connect’s technology, has developed a behavioral health care network model called ONECare that is yielding impressive results.
Behavioral Health Access Drives Millions in Total Cost of Care Savings
The ONECare network model is an organized, self-governed technology-enabled, and professionally managed network of outpatient, inpatient, crisis, and residential behavioral health providers. It was initially developed in partnership with a 1000-bed community safety net health system in the Raleigh, NC area. The network providers agree to use common screening and risk management protocols to ensure that patients are seen quickly by the appropriate provider and receive any additional support that may be necessary. They also use tools that can be leveraged by all providers across the community, such as Infina Connect, to crosswalk patient needs to provider capabilities and coordinate care. Within 18 months of deployment, the ONECare network achieved the following:
- >70% reduction in avoidable bed days and hospitalization
- >50% drop in average length of stay
- >20% drop in behavioral health admissions
- $33M total cost of care savings
The ONEcare network model has subsequently been deployed in other regional areas and is yielding similar results.
The Time to Build Your Integrated Behavioral Health Network is Now
There are many lessons to learn from COVID-19. Perhaps one of the biggest ones is the reality that we can no longer sit on the sidelines when it comes to behavioral health integration. With behavioral health consumers and COVID-19 patients competing for our ED beds, we have to be able to quickly and effectively implement a team approach to care.
All it takes to get started is for one organization in the community to stand up and take the lead – a payer, a provider group, an ACO, or a hospital sponsor to convene a small, but trusted network of behavioral health and substance use disorder peer organizations. Once commissioned and network adequacy is established, the network will offer priority access to focus on the urgent needs of the Behavioral Health population being served. At this point, the regional network becomes an attractive partner network to organizations that are seeking to improve clinical and cost outcomes for both specialty and polychronic behavioral health populations.
Interested in sponsoring a ONECare network in your area? Email me at firstname.lastname@example.org. We’ll schedule a joint call to answer any questions you may have and then get started. It’s that easy. Really.